Monday, February 15, 2016

Too often QIDP/QDDP's feel the urge to cure or come up with all the answers. It is not entirely the QIDP's fault. It often goes back to the organization that places everything on the shoulder's of the QIDP. The general feeling becomes "Send it to the Q, he or she will know what to do." While all QIDP's wish they had all the answers, the fact is nobody has all the answers. This was recognized years ago when the federal standards for ICF/IID programs were first developed. That is why the standards set forward the need for an IDTeam approach.

For the few reading this who may not know, IDTeam stands for Interdisciplinary Team. Just like the word says, it means a team approach from a group of different disciplines. Input can be taken from the QIDP, shift managers, direct care staff, nurses, administrators, physicians, dentist, and other specialist. All this input comes together to form the IDTeam. Generally meetings are held with the client (person served), their guardian or involved family member, the QIDP, a manager, a direct care, and a nurse at minimum. Everyone brings input from different areas to help solve a problem. For example, the nurse may present the physician's recommendations for a new medication, a direct care staff may point out some informal training that has worked with the client, the involved family member may know routines that helped at home, and the client may be able to tell everyone how he or she feels about something.

When the IDTeam comes together it is not the responsibility of the QIDP to have or present all the ideas. It is the QIDP's responsibility to coordinate the ideas and implement the ones the IDTeam agrees to.

I watched this concept recently demonstrated in an ICF/IID program where the Floor Supervisor, Sarah Ostlund, presented a unique idea to help a client stop slamming the door to his bedroom into the wall. While everyone was considering medications, one-on-one staff, and even expensive door control devices, Sarah obtained a simple pool noodle, cut it in three pieces and attached them by screws to the back of the door. After some experimentation, she found that the client would still slam the door, but now the effect was softened by the pool noodle. Sarah presented the idea and her results to an IDTeam that was seeking more expensive means to address the problem.

Once presented, the IDTeam adopted the swimming noodles attached to the client's door as part of the IPP. Eventually, without the results of damaged walls and the loud noise, the facility saw a decrease in the door being slammed open by this client.

In all honesty, had the IDTeam depended solely on the QIDP to come up with an idea, it is very likely that a new behavior plan, an increase of one-on-one staff, and maybe even medication modifications would have been tried first. Sarah ended up saving the facility and the client from a lot of undue expenses and hardships. The swim noodle, that I now call a "Door Noodle" continues to work at this time.